Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters

Introduction Studies show that physicians and medical trainees who identify as underrepresented in medicine or as women experience higher rates of microaggressions during patient encounters. We designed, implemented, and evaluated an active bystander training workshop focused on mitigating microaggr...

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Main Authors: M. Leila Famouri, Sean Hernandez, Rebecca L. Omlor, Montez Lane-Brown, Sally M. Evans, David McIntosh, Nancy Denizard-Thompson
Format: Article
Language:English
Published: Association of American Medical Colleges 2023-01-01
Series:MedEdPORTAL
Subjects:
Online Access:http://www.mededportal.org/doi/10.15766/mep_2374-8265.11298
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author M. Leila Famouri
Sean Hernandez
Rebecca L. Omlor
Montez Lane-Brown
Sally M. Evans
David McIntosh
Nancy Denizard-Thompson
author_facet M. Leila Famouri
Sean Hernandez
Rebecca L. Omlor
Montez Lane-Brown
Sally M. Evans
David McIntosh
Nancy Denizard-Thompson
author_sort M. Leila Famouri
collection DOAJ
description Introduction Studies show that physicians and medical trainees who identify as underrepresented in medicine or as women experience higher rates of microaggressions during patient encounters. We designed, implemented, and evaluated an active bystander training workshop focused on mitigating microaggressions using standardized patient (SP) methodology. Methods Internal medicine faculty members and chief residents led the workshop. Participants included 31 PGY 1 categorical and preliminary internal medicine residents. They participated in three case simulations with SPs involving microaggressions from patients toward a member of the health care team. Prior to the case simulations, a brief presentation outlined examples of microaggressions and reviewed the behavioral response framework WAKE (work with who you are, ask questions/make direct statements, involve key people, and employ distraction techniques). After each encounter, residents debriefed with an internal medicine faculty member and discussed questions related to each scenario. Results All 31 residents participated in the workshop and, before and after the activity, completed a survey that asked them to rank their agreement with statements via a Likert scale. Participants reported statistically significant improvement in recognizing microaggressions (12% reported increase, p = .002), the ability to respond to patients who exhibit microaggressions (23% reported increase, p < .001), and the ability to debrief with team members (20% reported increase, p < .001). Discussion SP simulations can be an effective teaching modality for microaggression response strategies during patient encounters. Additional studies are needed to further characterize the workshop's effect on other medical workforce trainees and retention of skills over time.
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spelling doaj.art-72b8ae4c1e214dff9ff6815a365908562023-01-31T05:00:07ZengAssociation of American Medical CollegesMedEdPORTAL2374-82652023-01-011910.15766/mep_2374-8265.11298Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient EncountersM. Leila Famouri0Sean Hernandez1Rebecca L. Omlor2Montez Lane-Brown3Sally M. Evans4David McIntosh5Nancy Denizard-Thompson6Assistant Professor, Department of Medicine, University of Wisconsin School of Medicine and Public HealthAssistant Professor, Department of Medicine, Wake Forest University School of MedicineAssistant Professor, Department of Medicine, Wake Forest University School of MedicineManager, Office of Inclusion and Diversity, Atrium-Wake Forest Baptist HealthPrevention Education Trainer, Campus Health Services, University of LouisvilleVice Dean for Justice, Equity, Diversity, and Inclusion, University of California, Los Angeles, David Geffen School of MedicineAssociate Professor, Department of Medicine, Wake Forest University School of MedicineIntroduction Studies show that physicians and medical trainees who identify as underrepresented in medicine or as women experience higher rates of microaggressions during patient encounters. We designed, implemented, and evaluated an active bystander training workshop focused on mitigating microaggressions using standardized patient (SP) methodology. Methods Internal medicine faculty members and chief residents led the workshop. Participants included 31 PGY 1 categorical and preliminary internal medicine residents. They participated in three case simulations with SPs involving microaggressions from patients toward a member of the health care team. Prior to the case simulations, a brief presentation outlined examples of microaggressions and reviewed the behavioral response framework WAKE (work with who you are, ask questions/make direct statements, involve key people, and employ distraction techniques). After each encounter, residents debriefed with an internal medicine faculty member and discussed questions related to each scenario. Results All 31 residents participated in the workshop and, before and after the activity, completed a survey that asked them to rank their agreement with statements via a Likert scale. Participants reported statistically significant improvement in recognizing microaggressions (12% reported increase, p = .002), the ability to respond to patients who exhibit microaggressions (23% reported increase, p < .001), and the ability to debrief with team members (20% reported increase, p < .001). Discussion SP simulations can be an effective teaching modality for microaggression response strategies during patient encounters. Additional studies are needed to further characterize the workshop's effect on other medical workforce trainees and retention of skills over time.http://www.mededportal.org/doi/10.15766/mep_2374-8265.11298MicroaggressionBystander TrainingAnti-RacismBiasCase-Based LearningCommunication Skills
spellingShingle M. Leila Famouri
Sean Hernandez
Rebecca L. Omlor
Montez Lane-Brown
Sally M. Evans
David McIntosh
Nancy Denizard-Thompson
Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
MedEdPORTAL
Microaggression
Bystander Training
Anti-Racism
Bias
Case-Based Learning
Communication Skills
title Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
title_full Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
title_fullStr Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
title_full_unstemmed Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
title_short Active Bystander Training: Using Standardized Patient Methodology to Teach Residents to Navigate Microaggressions in Patient Encounters
title_sort active bystander training using standardized patient methodology to teach residents to navigate microaggressions in patient encounters
topic Microaggression
Bystander Training
Anti-Racism
Bias
Case-Based Learning
Communication Skills
url http://www.mededportal.org/doi/10.15766/mep_2374-8265.11298
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